September 2007 - Its been six months

Its been almost six months since my bileteral pneumothorax.

I had my last check-up at St. Vincents Hospital Outpatients recently, where i got to meet with the consultants Mr. Gavin M. Wright and Mr. Naveed Zeb Alam (pictured).

Gavin M. Wright

I vaguely recall Gavin in a business suit, approaching my bed not long after the operation, and I will never forget Naveed clamping my rear intercostal catheter and immediately saying it could be removed. This meant I could lay in the hospital bed and get some decent sleep for the first time in a week.

Naveed Zeb Alam

I owe my life to these two gentlemen, and it was very informative to talk with them again, this time free of the effects of large amount of pain killers.


Gavin informed me that my left lung is recovering well, and has pleurodised right up to the top, and down to the diagphram. This explained the sensation of tightness around my bottom rib on the left-side, occassionally requiring Oxycontin. Gavin suggested that the lung will stretch in time. Gavin also told me that he found abnormalities on the right lung, and wanted to pleurodise the right lung ASAP.

In a subsequent appointment with Naveed, we came to the agreement that ive had a pretty rough time with the left lung pleurodesis, and they understand that I need more time to gain confidence in it before proceeding. We agreed that i'd call them when (if) im ready.

The past six months has been a struggle with recovery and depression, but i think the worst is over now. Unfortunately I'm still smoking a little, and I haven't run, ridden my bike or played soccer since the operation.

I'm ready to start yoga exercises to try and stretch the lung, as well as some light cardio-vascular exercises to improve the lung capacity. Hopefully lead to a more normal life, free from pain.

19 March: Not again!

The very next morning, Monday 19th March, I woke with similar pain and shortness of breath. I presented to the local GP, thinking "I'll just get this checked before going to work". With his stethoscope, he could hear the right lung was ok.....but very little air was entering the left lung...and sent me back to hospital.

While joking with the hospital staff about how "I liked the service that much that I've returned", they xrayed me and confirmed a spontaneous primary pneumothorax of the left lung.
This time the xray was a different picture, as the left lung had only collapsed 50% or so.

The hospital immediately inserted an intercostal catheter, thoraseal and suction, this time on the left underarm. I wasn't worried because I figured I'd be out in a few days, but because I'd had both lungs collapse within days, the local hospital organised a transfer to Cardiothorasic specialists in Melbourne, at St. Vincents Hospital Cardiothorasic Unit.

St. Vincents recommended I undergo a "VATS pleurodesis" operation on both lungs, an operation which they told me they use a powder to stick the lining of the lung to the lining of the chest wall. They mentioned the positive - in that this meant the left lung could never fully collapse again, but mentioned no negative.

My discharge notes read as such "He underwent VATS pleurodesis and apical wedge resection on 20 March 2007. Post op he unfortunately had a large air leak. His intercostal catheter was on suction for the 1st 48 hours however his air leak persisted for 1 week. We clamped his tube on 27 March 2007 and he again developed a pneumothorax on the left - so it was decided to take him back to theatre for a redo VATS and pleurectomy. Intra Op we couldn't isolate a leak site. Again his leak persisted post op".

Two catheters made sleeping very difficult

I had two catheters now - one in the front of my chest and one in my back, connected to the Thoraseal device with suction. This made sleep very difficult. After a week of continious suction, and little sleep, xrays showed partial success - in that 70% of my left lung had adhered to the chest wall, but i was still leaking air.

Luckily my oxygen saturation levels were staying high, because this allowed the hospital to discharge me on Friday 6th April, with a catheter still in the front of my left chest and a pneumostat device attached. The pneumostat is a one way air valve designed to let pressure out, stopping a tension pneumothorax. I realised this was a short term fix, but was happy to be out of hospital.

Just before discharge, they attached this pneumostat device.

Within a few days, I presented to the local hospital with a high level of pain and shortness of breath. I thought that the lung had collapsed again, but this turned out to be nerve pain around the site. With additional medication I was discharged the same day.

Within one week of discharge , I noticed the pneumostat had stopped whooshing air when I talked, coughed or sat on the toilet and pushed.

Exactly one week after discharge, I returned to St. Vincents Hospital and they confirmed the left lung had stopped leaking, then removed the catheter and pneumostat device. One of the happiest days of my life right there !

15th March: So Thats What a pneumothorax is!

On Thursday 15th March 2007, I woke with intense pain on the right side of my chest, and shortness of breath. I was doubled over and struggled to suck in any air, but managed to have a shower and get in the car and drive. As I headed to work, I passed the local hospital and realised that I was finding it hard to concentrate on the road, so maybe I should get this checked.



At Werribee Mercy Hospital, I presented at the emergency department and with their stethoscopes, the triage nurse could tell there was no air entering my right lung. Within minites they organised an x-ray to confirm a total collapse of the right lung - a spontaneous primary pneumothorax of the right lung.

The right lung is flat, like a popped balloon.

In the xray, the left lung looked like half an apple, but the right lung looked like a popped balloon. The doctors then asked if they could take a copy of the x-ray for training purposes, as they'd never seen such a complete collapse before. At this point I was starting to realise that I had a serious problem, but figured I'd be fixed soon.

The doctors inserted an intercostal catheter - a piece of plastic hose - into my chest, just below my right underarm, and connected that catheter to a Thoraseal 'water box' device, which in turn was connected to suction. I'll never forget the loud whoosh of air that came from me as they inserted the intercostal catheter.

The catheter in my right chest is clamped and the right lung is staying inflated

Werribee Mercy Hospital kept me connected to the Thoraseal and suction for 2 days and x-rayed me periodically. These x-rays confirmed that the right lung was slowly reinflating, and when they disconnected suction on Saturday 17th March, and clamped the catheter, continued xrays confirmed that the right lung stayed inflated.


On the 4th day, Sunday 18th March, they removed the catheter and continued xraying me. I left the hospital that afternoon and thought "What the hell happened there!".